After a successful run of original Emergency Room medical simulation games, highlighting the life-and-death dramas faced by doctors and nurses, Legacy Interactive sets this medical adventure in the emergency room of Chicago's County General Hospital, the fictional home of the hit NBC television series ER. Players take the role of a new intern assigned to the hospital. Like earlier games in Legacy's niche, such as Disaster Strikes, Life or Death, Code Blue, Code Red, and others, ER challenges virtual medics to pay close attention to their patients, and sometimes make life-or-death decisions on the spot. Joined by familiar characters such as Doctors John Carter, Susan Lewis, and Gregory Pratt, players will also be challenged by hospital politics and ethical dilemmas, and may even find time for a steamy workplace romance.

We have Doctors Carter, Pratt and Lewis, all fresh from County General, and all voiced very nicely by their respective actors. ER, the game, places you as a new intern in Chicago's County General Hospital, ready, willing, and potentially able to heal the sick and further your career.

Legacy Interactive has really done a fine job of late with the Law & Order spin-off games, particularly number 3 - Justice Is Served. For these, they secured top-notch writing and acting, presented in a context of very satisfying gameplay. Fortunately, we find a similar level of care and craftsmanship evident with ER, perhaps with some room for improvement as regards gameplay in future episodes.

Much in the same vein as one of my all-time favorites, Theme Hospital, ER is part sim, part RPG, part strategy. The TV show is both medical drama and soap opera. ER, the game, is mostly soap opera - sometimes literally, in your recurring need to wash up! First, of course, you need to create a character - male or female, with appearance options. Then, in RPG-like fashion, you have a number of stars you can assign to personality traits - intelligence, constitution, dexterity, charm. A bit oddly, perhaps, these affect your skill in specialities - general surgery, orthopedics, cardiology, toxicology, neurosurgery, pediatrics. You start with 10 stars, having the potential to build to 40 - ten for each trait.

In a very effective tutorial (there is no manual), Dr. Carter takes you patiently through the steps and nuances of your beginnings at County. There are a lot of rooms, nooks and crannies for you to explore in the two stories of the ER at General. Dozens of staff and patients wander about, presenting opportunities for interaction. Through each of the seven episodes, you have the overall goal of improving your skills, ability to heal and, as importantly, your career status and potential advancement. Whoever said doctors were in it just for love of the sick? You'll find you have three "stats" that not only need constant improving, but also can dangerously diminish - hygiene, energy and composure. You need to occasionally shower, work out in the gym, take naps and build relationships - sometimes with willing nurses (only heterosexual affairs are encouraged). Much like The Sims, conversation bubbles arise above the heads of approached NPCs, presenting options for interaction, enabled by a substantial menu at the bottom of the screen. As the game progresses, there may be accumulated payoffs or setbacks, depending on how the "staff" come to view you.

As the pictures demonstrate, ER is presented in a bit dated, but still very effective, 3D top-down world, with ability to rotate and zoom. It ran very nicely on my moderate level system. Script and voice acting are excellent, particularly from Dr. Carter (Noah Wiley). Indeed, interface, mouse/keyboard control, an effective minimap and other technical aspects of the game are well done. Yet this is a good place to comment on the strange lack of a manual, either paper or on the CD. The tutorial is thorough, but I had to make notes on keyboard commands and interface labels for future reference. There should, at least, have been a card containing such information.

Well, no one really says that, but one feels like our intern is performing an exorcism when he/she employs healing skills on a patient. In the ER, our intern learns to triage, call for help ("curbsiding"), assign to a bed, ask for lab tests, and actually lay on the hands. Sometimes this humorously animated little sequence works, sometimes it doesn't. It's all part of the learning. Actually, the sequences and options can become a bit redundant, maybe like the real life of an intern. Saving this, however, are the interaction possibilities (which can become weird if you want them to be), the career advancement concern, overall personal "health bar" worry, and the scripted events in the seven episodes. These range from the mildly serious to the mostly humorous. You'll deal with the results of a car accident, a fire at a superhero convention, the loss of power due to a wrecking ball crashing through the wall, a clown, a wealthy socialite, and others. There are major tasks within each episode, as well as many minor objectives, all keeping you busy within your shift. All the while, of course, you have your personal health, relationships and goals to keep in mind. It can be hectic, but not as much as Theme Hospital, and you can save your game within episodes, thank goodness!

Aficionados of pure sim and RPG games might well scoff at this cross-genre representation of the famed TV series. The game is admittedly not as deep or detailed as Planescape Torment or The Sims 2. But ER does bring these game styles together to create an entertaining, fairly unique play experience. As you modify your character and move through the episodes, you'll be kept busy, but not in a frantic way. You'll need to balance your actions, relationships, priorities - service to self as well as others!

ER is not a terribly complicated game, with a setting and tasks that are limited in scope. Yet fans of the show, and those desiring a bit different sim experience, will undoubtedly find laughs and enjoyment in this light-hearted depiction of an intern's first days.